Financial Rewards Motivate Health Behavioral Change

As the world struggles with an obesity epidemic, experts recommend incentives to motivate individuals to perform healthy activities — be it recognition for walking 10,000 steps a day, or obtaining some form of monetary reward after performing a health enhancing behavior.

A new study finds that financial incentives are effective as people are more likely to choose healthy options at the grocery store if they use the risk of losing their monthly healthy food discount as a motivational tool.

The research, as published in journal Psychological Science, adds to a body of work aimed at understanding which factors are most effective for increasing healthy behaviors.

The power of a financial incentive can motivate people to do a lot of things, but constantly doling out increasing amounts of money to keep incentives going over the long term might quickly sap institutional coffers or prove ineffective.

“We tried to think of an incentive design that would give people better self-control but wouldn’t involve increasing incentive amounts,” said co-authors Drs. Janet Schwartz and Daniel Mochon.

“People can be quite sophisticated or self-aware of their self-control problems,” the Tulane University researchers note.

“In light of this, they may welcome opportunities that help resist temptation even at the risk of some penalty.”

Schwartz, Mochon, and colleagues hypothesized that shoppers who agreed to put their grocery discount on the line would be more likely to make healthier choices at the grocery store.

The researchers conducted a randomized controlled experiment with over 6,500 households enrolled in the Discovery Health Vitality Rewards program in South Africa.

In the study some households were given an opportunity to voluntarily precommit to a goal of increasing their healthy food purchases by 5 percentage points over their historical average for each of the six months in the study.

So, a household whose grocery purchases were composed of 25 percent healthy foods, on average, would be asked to increase the healthy foods quotient to 30 percent.

For some, this amounted to adding only a few more vegetables or low-fat foods per trip at the risk of forfeiting their entire monthly cash-back discount on all healthy foods.

The data revealed that only the households who volunteered to put their cash-back discount on the line increased their healthy food purchases — by an average of 3.5 percentage points — over each of the six months in the study.

This was compared to households who chose not to risk their discount and a control group who had no opportunity to make a financially binding commitment.

Even though some families didn’t reach the goal each month, the researchers were surprised by their resiliency:

“Those who failed the task — who did not get the discount — nevertheless wanted to stay in the program,” explains psychological scientist and study co-author Dan Ariely of Duke University.

“These were people that tried to use the financial penalty to improve their own behavior and failed to do so. But they did not blame anyone else, and they did not stop trying.”

These findings call into question the assumption that more information is all people need in order to make better decisions:

“People sometimes know what the right thing to do is, but they’re not able to act on that,” Ariely explains.

“If we want people to behave better, what we need to do is not provide them with more information, but instead help them change their environment.”

The new research indicates that people really do understand the importance of purchasing healthy foods, and are even willing to put a constraint on themselves as a way of changing their environment in order to try to achieve that goal.

Building off of these initial results, the researchers want to know whether the precommitment strategy caused participants to continue buying healthy foods even after the risk of losing money went away, and what effects this strategy has on other health behaviors.

“Were people so inspired by their commitment to healthier eating that they exercised more? Or was it the reverse, where healthier nutrition lead to exercise slacking?” Schwartz and Mochon said.

“Our future field studies will focus on voluntary commitment devices in other health behaviors, such as gym exercise and smoking cessation, which can work in large-scale incentive programs and help people maintain self-control on an ongoing basis.”

“The range of issues that we want to study is very broad — including eating, exercise, smoking cessation, even education — and these data give us the lens to look at all of those,” Ariely said.

Last reviewed: By John M. Grohol, Psy.D. on 7 Jan 2014 Published on PsychCentral.com. All rights reserved.

About Rick Nauert PhD

Dr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.